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1275242869
KEVIN GRANT FACKLER
LOUISVILLE, KY
NPI
1275242869
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: IN 99114992A)
Enumeration Date
2022-11-22
Last Update Date
2023-09-25
Business Address
KEVIN GRANT FACKLER TSW
4922 LAGOONA DR
LOUISVILLE, KY 40219-5404
Phone number: 502-396-2358
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Mailing Address
KEVIN GRANT FACKLER TSW
4922 LAGOONA DR
LOUISVILLE, KY 40219-5404
Phone number: 502-396-2358
Copy
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